PREOPERATIVE AND EARLY POSTOPERATIVE FACTORS ASSOCIATED WITH VISUAL OUTCOME AFTER MACULAR-OFF RETINAL DETACHMENT SURGERY.

IF 2.1 2区 医学 Q2 OPHTHALMOLOGY Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2025-06-01 DOI:10.1097/IAE.0000000000004416
Yuan Zhao, Yan Sheng
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Abstract

Purpose: To evaluate preoperative and early postoperative factors associated with changes in visual acuity in patients with macula-off rhegmatogenous retinal detachment.

Methods: A retrospective review of 59 eyes from 59 patients who underwent pars plana vitrectomy and silicone oil tamponade for macula-off rhegmatogenous retinal detachment. Preoperative and early postoperative characteristics were analyzed using the classification and regression tree analysis.

Results: The baseline preoperative best-corrected visual acuity improved from 1.67 ± 0.97 the logarithm of the minimum angle of resolution to 0.21 ± 0.22 the logarithm of the minimum angle of resolution at the final visit. Central foveal thickness and best-corrected visual acuity showed significant increases from 1 week postsurgery onward. The mean Central foveal thickness significantly increased from 136.97 ± 40.17 µ m to 192.54 ± 34.09 µ m ( P < 0.001). The percentage of eyes with integrated external limiting membrane and ellipsoid zone was progressively increased from 45.76% and 10.17% to 98.31% and 71.19%, respectively ( P < 0.001). Best-corrected visual acuity at 1 week after surgery, external limiting membrane integrity, preoperative intraretinal cysts, and macula-off duration were significantly associated with final visual recovery after surgery. In particular, patients whose best-corrected visual acuity at 1 week were not more than 0.7 logarithm of the minimum angle of resolution, without preoperative intraretinal cysts, and operated on within 15 days of initial symptoms had the best predicted final vision of 0.006 logarithm of the minimum angle of resolution.

Conclusion: The first week postoperative best-corrected visual acuity is the most powerful predictor for final best-corrected visual acuity. External limiting membrane integrity, intraretinal cysts, and macula-off duration are also significantly associated with final visual recovery.

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黄斑脱离视网膜手术术前及术后早期影响视力的因素。
目的:探讨无黄斑的孔源性视网膜脱离(RRD)患者术前及术后早期影响视力变化的相关因素。方法:回顾性分析59例玻璃体切除(PPV)加硅油(SiO)填塞治疗黄斑脱落型RRD患者的59只眼。采用分类回归树(CART)分析术前和术后早期特征。结果:术前基线BCVA从1.67±0.97 logMAR改善到最后一次就诊时的0.21±0.22 logMAR。术后1周中央中央凹厚度(CFT)和BCVA显著增加。平均CFT由136.97±40.17 μm增加至192.54±34.09 μm (p < 0.001)。整体外限制膜(ELM)和椭球带(EZ)的比例分别由45.76%和10.17%逐渐增加到98.31%和71.19% (p < 0.001)。术后1周BCVA、ELM完整性、术前视网膜内囊肿、黄斑消失时间与术后最终视力恢复显著相关。结论:术后第一周BCVA是最终BCVA的最有效预测指标。ELM的完整性、视网膜内囊肿和黄斑消失的持续时间也与最终的视力恢复显著相关。
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来源期刊
CiteScore
5.70
自引率
9.10%
发文量
554
审稿时长
3-6 weeks
期刊介绍: ​RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.
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